Poverty and childhood overweight in California Assembly districts

Objectives: The goal of the present study was to determine the association between childhood overweight and area-based socioeconomic indicators in California Assembly districts. Design: A cross-sectional ecologic study. Participants: California public school students. Main exposure: Poverty and demographic data for California Assembly districts were based on the 2000 Census and obtained from the UCLA Center for Health Policy Research. Outcome measures: Overall and race- and ethnicity-specific rates of childhood overweight for California Assembly districts (n = 80) were based on the 2004 statewide Fitnessgram evaluation of California public school students. Results: Poverty was significantly associated with childhood overweight in California Assembly districts. At the Assembly district scale, childhood overweight was significantly associated with percent residents below poverty for the entire population (r = 0.82), and with the race/ethnicity-specific overweight prevalence for African-American (r = 0.43), Latino (r = 0.61) and White (r = 0.54) populations. There was also evidence that childhood overweight in California Assembly districts was spatially clustered. Linear regression models confirmed that percent of residents below poverty was an independent predictor of a higher prevalence of childhood overweight for the entire population. The results of race/ethnicity-specific models confirmed that the association between area poverty and childhood overweight was not explained by differences in the risk of overweight among specific race/ethnicity groups. Conclusions: Area-based measures of socioeconomic status can be used to identify problem areas and can be used for optimal targeting of public health prevention and intervention efforts. (C) 2008 Elsevier Ltd. All rights reserved.